Three studies (n=996 participants) were included in the analysis. All studies were of high quality (scored 4 on the Jadad scale).
Denosumab was not associated with a statistically significant reduction in fracture risk (OR 0.74, 95% CI 0.33 to 1.64; three studies). There was no evidence of statistically significant heterogeneity or publication bias.
Denosumab was associated with a statistically significant increased risk of serious adverse events (OR 1.83, 95% CI 1.10 to 3.04, NNH 20, 95% CI 9 to 150; three studies) and serious infections (OR 4.45, 95% CI 1.15 to 17.14, NNH 50, 95% CI 12 to 1,119; three studies).
There was no statistically significant difference in in mortality rate or risk of neoplasm and drop-out due to adverse event. There was no evidence of statistically significant heterogeneity or publication bias.